Individual
BRANDON FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7026 OLD KATY RD STE 276, HOUSTON, TX 77024-2187
(713) 358-0562
Mailing address
1020 S MESA HILLS DR, #4912, EL PASO, TX 79912-5106
(214) 991-8327
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
Q2280
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2013
Last updated
06/27/2019
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